Huge 2011 study: Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009

This review by Dr. Priscilla K. Coleman (found in The British Journal of Psychiatry (2011)199, 180–186. doi: 10.1192/bjp.bp.110.077230) offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion.

Request a copy of the article by email from the author at pcolema@bgsu.edu

Abstract can be found at http://bjp.rcpsych.org/content/199/3/180.abstract

Abstract

Background Given the methodological limitations of recently published qualitative reviews of abortion and mental health, a quantitative synthesis was deemed necessary to represent more accurately the published literature and to provide clarity to clinicians.

Aims To measure the association between abortion and indicators of adverse mental health, with subgroup effects calculated based on comparison groups (no abortion, unintended pregnancy delivered, pregnancy delivered) and particular outcomes. A secondary objective was to calculate population-attributable risk (PAR) statistics for each outcome.

Method After the application of methodologically based selection criteria and extraction rules to minimise bias, the sample comprised 22 studies, 36 measures of effect and 877 181 participants (163 831 experienced an abortion). Random effects pooled odds ratios were computed using adjusted odds ratios from the original studies and PAR statistics were derived from the pooled odds ratios.

Results Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased risk occurred when abortion was compared with term pregnancy and when the outcomes pertained to substance use and suicidal behavior.

Conclusions This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.

AAPLOG Summary of Coleman article:

The article is comprised of 22 studies from 6 countries, 36 measures of effect and 877,181 participants (163,831 experienced an abortion). This review offers the largest estimate of mental health risks associated with abortion available in the world literature. The results revealed an 81% increased risk of mental health problems after abortion.

Separate effects were calculated based on the type of mental health outcome with the results revealing the following: the increased risk for anxiety disorders was 34%; for depression it was 37%; for alcohol use/abuse it was 110%, for marijuana use/abuse it was 220%, and for suicide behaviors it was 155%.

When compared to “unintended pregnancy delivered,” “pregnancy aborted” women had a 55% increased risk of experiencing any mental health problem.

Clearly, this article substantiates that abortion is a poor solution for an undesired pregnancy (and note that most abortions are done ostensibly to avoid emotional distress of some kind. These women are not avoiding emotional distress.)